Adult ; Coal Mining ; Humans ; Male ; Pneumoconiosis ; classification ; diagnostic imaging ; Radiography ; Reference Standards

Objective: To evaluate the effect and clinical significance of early enteral nutrition in postoperative patients with malignant obstructive jaundice. Methods: Thirty patients with malignant obstructive jaundice were randomized into postoperative early enteral nutrition (EN) group and parenteral nutrition (PN) group. Results: The body weight and level of prealbumin, albumin, transferrin decreased significantly after operation in both group, and there was no significant difference between two groups. Nitrogen balance was positive in the EN group, but it was negative in the PN group. EN had less influence on hepatic enzymes than PN. The economic consumption in EN group was less than that in PN group. Conclusions: Compared with PN, early EN support can ameliorate malnutrition state in postoperative patients with malignant obstructive jaundice more safely, effectively and economically.

Objective: To study the effect of selective portal vein embolizationon (SPVE) on the second-stage hepatectomy rate in patients with primary hepatocellular carcinoma(HCC). Methods: Eighteen patients with HCC who were not suitable for hepatectomy were treated by ultrasonic guided percutaneous transhepatic SPVE with fine needles. Success rate of SPVE, adverse reactions, successive change of the volume of each liver lobe, and hepatectomy rate after treatment were observed. Results: SPVE were successfully performed in all 18 patients. In patients with right portal vein branch embolized, the right liver volume decreased while left liver volume increased gradually. The rate of right lobe volume to total liver volume decreased from 62.9 % before SPVE to 60.6 % after l week, 57.5 % after 2 weeks and 53.0 % after 3 weeks. The adverse reactions included different degrees of pain in liver area (12 cases), lower fever (7 cases), nausea and vomiting (4 cases). After 2-4 weeks, second-stage hepatectomy for HCC were successfully performed in l0 patients (55.6 %). Conclusion: Ultrasonic guided percutaneous transhepatic SPVE is simple and effective. It can elevate the two-step hepatectomy rate of HCC and increase the safety of the operation.

Objective: To evaluate the feasibility and character of laparoscopic cholecystectomy (LC) in patients with histories of multiple upper abdominal surgeries(≥2 ). Methods: We retrospectively analyzed the results of 21 LC operations in patients who had previously accepted two or three upper abdominal surgeries . Results: LC were successfully performed in 13 of all the patients (61.9%). The success rate of LC in patients with 2 upper abdominal surgeries was 66.7%. It was only 33.3% in patients with 3 upper abdominal surgeries. Eight of the patients (38.1%) were transformed to open cholecystectomies. The mean operation time was 72.1 minutes. The transform rate was higher, and the mean operation time was longer than those without previous upper abdominal surgery at the same period in our department. Conclusion: History of multiple upper abdominal surgeries should not be regarded as the contraindication to laparoscopic cholecystectomy. But these operations were difficult with higher transform rate and longer operation time.

Evidence suggests that translocation of gut bacteria or their toxins is a major contributor to gut-derived sepsis and multisystem organ failure in critically ill patients.This review reevaluates the data from studies in animal models and humans on bacterial translocation.The new insights in mechanisms of bacterial translocation pathogenesis and its clinical relevance will help clinicians to make correct strategies to enhance gut function.

Objective To study the clinical application of trigemino-cervical reflex(TCR)in migraine without aura(MWOA)and chronic tension-type headache(CTTH).Methods The TCR was recorded using surface electromyographic recordings bilaterally from the sternocleidomastoid muscle after stimulation of infraorbital branch of the trigeminal nerve.The reflex was investigated in 25 patients with unilateral MWOA,25 patients with CTTH and 36 healthy subjects.The patients were outpatients who visited Fujian provincial institution hospitals from January 2009 to February 2010.Results Compared with the healthy subjects,the bilateral peak latency of P19/N31(PLP19 and PLN31)was significantly shortened in the subjects with MWOA(left and fight side were(19.49 ± 1.95)ms and(19.81 ± 1.79)ms respectively)or CTTH(left:(19.56 ±2.02)ms,and right:(19.16 ± 1.67)ms),t values were between 2.027 and 3.654,all P ＜ 0.05.The values of PLP19 and PLN31 between the patients with MWOA and with CTTH were not significantly different.Conclusions The peak latency of P19/N31 was shortened in the subjects with MWOA or CTTH,suggesting that the trigeminal and brainstem may participate in the pathophysiology of MWOA and CTTH.There was no significant difference in PLP19 and PLN31 between the patients with MWOA and CTTH,indicating similar abnormalities in the endogenous pain control mechanisms in both migraine and

Minimally invasive approach points toward one of the directions of the development of surgery in the new century.Based on endoscopy,laparoscopy and interventional technique,minimally invasive techniques have been more and more widely applied to abdominal surgery.Some have already replaced conventional open surgery and become the first option for the treatment of some diseases.Nevertheless,some problems and mistaken ideas do exist in the development of minimally invasive techniques,which call for our attention and proper solution.Combined use of different minimally invasive techniques represents the trend of the development of minimally invasive surgery,while virtual reality techniques,robotic techniques and remote minimally invasive techniques will be playing a leading role in the future.

The authors,in this paper,has briefly looked back the developmental history of human parasitology,which,as an independent discipline,was established in late 19th century and early 20th century.In the process,it underwent an early height of development,then met with setback and relative decline.Since 70s-80s of last century,the introduction and application of new theory of modern biology,especially advanced biotechniques to parasitology has led to a striking development in many fields of the discipline,leading to deeper understanding of parasite-host interplay as well as providing new ideals and tools for disease control.The authors also stressed that nowadays the discipline is still relatively isolated from the mainstream of modern biologic research and is still neglected by scientific community and medical education in the world,though it still is one of the major problems in public health,particularly in developing world including China.To argue the currently neglected situation of parasitology,especially in medical education,the authors emphasized the continuing requirements for the discipline and reflected on the developmental strategy of parasitology to meet the coming challenges and opportunities for further development.

OBJECTIVE:To investigate therapeutic efficacy and recurrence rate of vaginal administration of lactobacillus com-bined with chlorquinaldol-promestriene for senile patients with atrophic vaginitis. METHODS:150 senile patients with atrophic vag-initis were selected and divided into group A,B,C according to random number table,with 50 cases in each group. Group A was given Lactobacillus vaginal capsules,2 capsules,qd (at bedtime);group B given Chlorquinaldol-promestriene vaginal tablets,1 tablet,qd(at bedtime);group C given Chlorquinaldol-promestriene vaginal tablets,1 tablet,qd(at bedtime),and Lactobacillus vaginal capsules,2 capsules,qd,next morning,implanting into vagina. 3 groups received treatment for 18 d. Clinical efficacy, vaginal health score,vaginal symptom score and vaginal pH value were observed in 3 groups,and the occurrence of ADR and re-currence rate during follow-up period (12 months) were recorded. RESULTS:The total effective rate of group C was 94.00%, which was significantly higher than group A(72.00%)and B(74.00%),with statistical significance(P<0.05). Before treatment, there was no statistical significance in vaginal health score,vaginal symptom score and vaginal pH value among 3 groups (P>0.05). After treatment,vaginal health score of 3 groups were increased significantly,while vaginal symptom score and vaginal pH value were decreased significantly;and the improvement of above indexes in group C were significantly better than in group A and B,with statistical significance(P<0.05). No obvious ADR was found in 3 groups during treatment. The recurrence rate of group C during follow-up period(4.00%)was significantly lower than that of group A(18.00%)and group B(20.00%),with statistical significance(P<0.05). CONCLUSIONS:Vaginal administration of lactobacillus combined with chlorquinaldol-promestriene for se-nile patients with atrophic vaginitis can effectively relieve clinical symptoms and signs,improve vaginal cleanliness,regulate the lo-cal pH value and reduce the risk of recurrence,with good safety.

Objective To observe the effect of T cell subset in the children patients with community acquired pneumonia. Methods A total of 36 patients with community acquired pneumonia were enrolled and they were divided into 2 groups according to pathogen, bacterial infection group, and non-bacterial infection group. And in another way they were divided into severe cases group and non-severe cases group. Indexes of T lymphocyte subset CD3+, CD4+, CD8+, CD19+and activity of natural killer (NK) cell were detected in all patients by flow cytometry and compared. Results The levels of CD3+, CD4 +, CD8 +, CD19 + and NK cell had no significant difference between bacterial infection group and non-bacterial infection group (P>0.05). The levels of CD3+, CD4+and CD19+had no significant difference between severe cases group and non-severe cases group (P>0.05). But the level of CD8+ in severe cases group was significantly higher than that in non-severe cases group:(28.4 ± 7.8)%vs. (14.4 ± 3.5)%, P<0.01. The level of NK cell in severe cases group was significantly lower than that in non-severe cases group: (7.3 ± 2.1)%vs. (16.6 ± 5.4)%, P<0.01. Conclusions The children patients with community acquired pneumonia patients may develop into severe pneumonia with high percent of CD8+or low activity of NK cell. So they should be given immune intervention as soon as possible.